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Intravital and postmortem diagnostics of myocardial hypertrophy of the left ventricle:identity or convention?

S N Bogomolov1, A N Kulikov1,2, J A Tikhonova2

  • 1Military Medical Academy, St. Petersburg, Russia.

Terapevticheskii Arkhiv
|February 1, 2019
PubMed

Insights

New electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) show improved sensitivity and diagnostic accuracy compared to conventional methods. These novel ECG approaches better align with postmortem measurements of left ventricular mass (LVM).

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Pathology

Background:

  • Left ventricular hypertrophy (LVH) is a significant cardiovascular condition.
  • Accurate diagnosis of LVH is crucial for patient management.
  • Current diagnostic methods, including electrocardiography (ECG) and echocardiography (EchoCG), have limitations in assessing LVH accurately.

Purpose of the Study:

  • To evaluate the diagnostic performance of ECG and EchoCG for LVH against postmortem measurements of left ventricular mass (LVM).
  • To compare conventional ECG criteria with novel, author-developed ECG criteria for LVH detection.

Main Methods:

  • Analysis of anthropometric data, ECG, EchoCG, and postmortem LVM measurements in 15 patients.
  • Evaluation of conventional ECG criteria and author-developed ECG models (regression, discriminant analyses) for LVH.
  • Comparison of diagnostic accuracy using three postmortem LVH criteria: K. Bove (CB), A.M. Lifshitz (VI), and P. Casale (LVMI).

Main Results:

  • Conventional ECG criteria demonstrated high specificity but very low sensitivity for LVH detection.
  • Author's ECG criteria exhibited lower specificity but significantly higher sensitivity (54-75%) and diagnostic accuracy (60-66.7%) compared to conventional methods.
  • The diagnostic accuracy of the author's ECG criteria showed minimal dependence on the specific postmortem measurement method used.

Conclusions:

  • Conventional ECG criteria are generally insensitive for diagnosing LVH when compared to postmortem LVM.
  • The author's developed ECG criteria, incorporating sensitive electrocardiographic characteristics and sex/age-specific indices, offer superior sensitivity and diagnostic accuracy for LVH.
  • These findings suggest that advanced ECG analysis holds promise for more reliable non-invasive LVH assessment.
Abstract

Keywords:
autopsydiagnostic accuracyechocardiographyelectrocardiographyhypertrophy of left ventricular myocardiumsensitivityspecificitytotal body surface area

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